Haruhiko Furuta

Three lateral osteotomy designs for bilateral sagittal split osteotomy: biomechanical evaluation with three-dimensional finite element analysis

BackgroundThe location of the lateral osteotomy cut during bilateral sagittal split osteotomy (BSSO) varies according to the surgeons preference, and no consensus has been reached regarding the ideal location from the perspective of biomechanics. The purpose of this study was to evaluate the mechanical behavior of the mandible and screw-miniplate system among three lateral osteotomy designs for BSSO by using three-dimensional (3-D) finite element analysis (FEA).MethodsThe Trauner-Obwegeser (TO), Obwegeser (Ob), and Obwegeser-Dal Pont (OD) methods were used for BSSO. In all the FEA simulations, the distal segments were advanced by 5 mm. Each model was fixed by using miniplates. These were applied at four different locations, including along Champys lines, to give 12 different FEA miniplate fixation methods. We examined these models under two different loads.ResultsThe magnitudes of tooth displacement, the maximum bone stress in the vicinity of the screws, and the maximum stress on the screw-miniplate system were less in the OD method than in the Ob and TO methods at all the miniplate locations. In addition, Champys lines models were less than those at the other miniplate locations.ConclusionsThe OD method allows greater mechanical stability of the mandible than the other two techniques. Further, miniplates placed along Champys lines provide greater mechanical advantage than those placed at other locations.

Gabapentin therapy in patients with orofacial neuropathic pain: Report of 12 cases

Abstract Objective There are several types of orofacial neuropathic pain and some of these types are often refractory to treatment. Gabapentin is an oral antiepileptic agent with a proven analgesic effect in various traumatic neuropathic pain syndromes. We retrospectively examined the analgesic effect of gabapentin on non-dental and non-traumatic orofacial neuropathic pain. Subjects and methods This study included 12 patients. All patients showed an excessive response to noxious (hyperalgesia) and/or innocuous (allodynia) stimuli in the affected region. Gabapentin therapy was initiated with a dosage of 200–600mg/day. Pain intensity was assessed using a modified numerical rating scale (m-NRS) (0, no pain; 10, pain equal to that experienced on the day gabapentin therapy was initiated). In addition, the side effects were also recorded. Results All the patients had received medications for their pain prior to referral, but the drugs failed to provide adequate relief from their neuropathic pain. The m-NRS scores for all patients started decreasing within 7 days after internal use was initiated. The average time taken for the m-NRS score to decrease to half was 3.3 (1.7) days. Side effects were observed in 2 patients. Conclusion We concluded that gabapentin therapy is efficacious for the treatment of orofacial neuropathic pain in selected patients.

Results of questionnaire about informing cancer to informed oral cancer patients.

今回私達は九州歯科大学附属病院第一口腔外科にて加療し, 癌告知を受けた口腔癌患者32名中, 22名に癌告知に関するアンケートを施行し, 以下の結果を得た。(1) 15名 (68.2%) が真の診断名を知りたかったと答えた。一方, 3名 (13.6%) 知りたくなかったと答えたが, うち2名は最終的には癌告知に賛同していた。(2) 告知時期は全員術前を, 特に組織診断判明時を11名 (50%) が希望していた。また, 告知は主治医からを20名 (90.9%) が希望していた。(3) 告知が恐怖を生じさせる反面, 治療上プラスとなることが示唆された。(4) 家族が癌の場合の告知に関しては50%が「告知する」と答えた。以上の結果より, 口腔癌患者への癌告知を行う意義が示唆された。

Treatment to Skeletal Open Bite by Sagittal Splitting of Body of Mandible.

For correction of skeletal open bite with Angle class I, sagittal splitting of body of mandible has been performed.This surgical method can preserve the integrity of the inferior aspect of the mandibular body and alveolar crest and has obviated the necessity of bone grafting and making the precise model needed for conventional mandibular body ostectomy. In addition, the excellent interface of bone has promoted early consolidation of the proximal and distal segments.Therefore, sagittal splitting of the body of the mandible is an effective surgical procedure for skeletal open bite.

Epidemiologic Survey of the Patients with Dento-facial Deformity. Questionnarie Study.

Epidemiologic study was conducted bygiving a questionnaire to 414 patients (128 males, 286 females) who indicated surgical correction of dentofacial deformity to investigate etiologic factors. The same questionnaire was given to 482 dental students as the control group and statistically compared with the patient group. The results were as follows:1. The suggestive items of hereditary factors were recognized in the patient group, and many parents, brothers, and sisters of patients tended to have dento-facial deformity and familial congenital anomaly.2. Many patients tended to have suffered from abnormality in their mothers body during fetal stage and birth.3. Many patients tended to have any abnomality of skull morphology during childhood.4. There was no significance of facial traumatic anamnesis between patient and control groups.5. Patients who had many dental caries, oral habits, food preference, underwent orthodontic treatment or operation of jaw during childhood, and anamnesis of temporomandibular joint luxation were significantly more than those in the control group.The results of this study revealed that dento-facial deformity was caused by hereditary and environmental factors